NCT00220571

Brief Summary

The aim of this study conducted in patients with high risk ST-segment elevation AMI admitted to hospitals with no PTCA facilities is to compare the effects on clinical outcome and cost-effectiveness of two reperfusion strategies:

  • Fibrinolytic therapy with Abciximab and half-dose Reteplase, with rescue PTCA in case of lack of reperfusion
  • Elective referral for "facilitated" PTCA after early administration of Abciximab and half dose of Reteplase

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
600

participants targeted

Target at P75+ for phase_3

Timeline
Completed

Started May 2003

Typical duration for phase_3

Geographic Reach
3 countries

85 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

May 1, 2003

Completed
2.4 years until next milestone

First Submitted

Initial submission to the registry

September 13, 2005

Completed
9 days until next milestone

First Posted

Study publicly available on registry

September 22, 2005

Completed
1.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 1, 2007

Completed
Last Updated

July 3, 2007

Status Verified

September 1, 2005

First QC Date

September 13, 2005

Last Update Submit

July 2, 2007

Conditions

Keywords

AMIstentPTCAabciximabreteplasecombo therapy

Outcome Measures

Primary Outcomes (1)

  • To compare 30 days incidence of the composite end-point of: mortality, reinfarction and refractory ischemia in the two arms of the study.

    30 Day

Secondary Outcomes (3)

  • Compare 1 year composite end-point of: mortality, reinfarction, refractory ischemia, hospital readmission because of heart failure in the two arms;

    1 Year

  • Compare the resource use at 30 days and 1 year, including days in CCU, MICU or general ward, cost of catheterization and PTCA, drugs, ambulance service during index hospitalization and subsequent hospital admissions for reAMI

    30 Day and 1 Year

  • Compare the incidence of in-hospital stroke and bleeding complications in the two arms.

    30 Day

Interventions

Eligibility Criteria

AgeUp to 75 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • \- ECG with ST-elevation (≥ 1mm in at least 2 ECG limb leads or ≥ 2 mm in 2 contiguous precordial leads) AMI within \<12 hours from symptoms onset fulfilling 1 or more of the following criteria of "high risk":
  • Summation of ST-segment elevation or depression ≥ 15 mm in all 12 electrocardiographic leads or new onset complete left bundle branch block;
  • Previous myocardial infarction (Q- and non Q-wave);
  • Killip Class 2 or 3;
  • LV ejection fraction at transthoracic ultrasound \< 40%.

You may not qualify if:

  • Inability to provide informed consent;
  • Age \> 75 years
  • CABG or PCI procedure in past history involving the infarct-related artery;
  • Participation in another study with any investigational drug or device within the previous 30 days;
  • Concomitant non-cardiac disease likely to limit long-term prognosis (e.g. cancer);
  • Cardiogenic shock (hypotension with Systolic Blood Pressure (SBP) \< 90 mmHg and tachycardia \> 100 beats / min, not due to hypovolemia and requiring inotropic support or balloon counterpulsation);
  • Need for concomitant major surgery (e.g. valve surgery or resection of aortic or left ventricular aneurysm, carotid endarterectomy, abdominal aortic aneurysm surgery, congenital heart disease etc);
  • Severe hepatic disease;
  • Patients with acute or chronic renal impairment (serum creatinine \> 2.0 mg % or 200 mg/l or creatinine clearance \< 30 ml/min);
  • Transmural MI in different location within the previous week;
  • Previous administration of thrombolytics within 7 days;
  • Intolerance or contraindications to ASA or Clopidogrel;
  • Known leucopenia, defined as a leukocyte count of \< 3.500 White Blood Cells (WBC)/ml
  • Known neutropenia, defined as \< 1000 neutrophils / ml;
  • Known thrombocytopenia (\< 100.000 platelets / ml );
  • +11 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (85)

Cardiologie Hop. Duffaut

Avignon, 84902, France

Location

SAMU - Hop. Duffaut

Avignon, 84902, France

Location

Cardiologie - Hop. Louis Pradel

Bron, 69500, France

Location

Cardiologie - CH

Caen, 14033, France

Location

Urgences - CH

Carpentras, 84200, France

Location

Cardiologie - CH

Cherbourg, 50100, France

Location

SAMU - Hop. Beaujon

Clichy, 92110, France

Location

Service de Cardiologie - Hopital St. Joseph

Colmar, 68024, France

Location

Cardiologie - CHU

Grenoble, 38043, France

Location

Samu - Chu

Grenoble, 38043, France

Location

SAMU 69 - Hop. E. Herriot

Lyon, 69437, France

Location

Cardiologie - Hop. Bichat

Paris, 75018, France

Location

Centre Cardiologique du Nord

Saint-Denis, 93200, France

Location

SMUR Delafontaine

Saint-Denis, 93200, France

Location

SAMU - Reanimation - CH

Sélestat, 67604, France

Location

Ospedale San Donato

Arezzo, 50100, Italy

Location

Presidio Ospedaliero del Casentino

Bibbiena, 52011, Italy

Location

Spedali Civili

Brescia, 25123, Italy

Location

Az. Ospedaliera di Circolo

Busto Arsizio, 21052, Italy

Location

P.O. di Camposampiero

Camposampiero, 35012, Italy

Location

Ospedale Ramazzini

Carpi, 41012, Italy

Location

Ospedale Bufalini

Cesena, 47023, Italy

Location

P.O. Cittadella

Cittadella, 35013, Italy

Location

P.O. di Codogno

Codogno, 26845, Italy

Location

Ospedale di Conegliano

Conegliano, 31015, Italy

Location

Ospedale S. Giuseppe da Copertino

Copertino, 73043, Italy

Location

Ospedale S. Sebastiano

Correggio, 42015, Italy

Location

P.O. di Cortona

Cortona, 52044, Italy

Location

Ospedale Santa Croce e Carle

Cuneo, 12100, Italy

Location

Ospedale di Desio

Desio, 20033, Italy

Location

Ospedale Santa Maria del Prato

Feltre, 32032, Italy

Location

Ospedale S. Sebastiano Martire

Frascati, 00044, Italy

Location

Ospedale Santa Caterina Novella

Galatina, 73013, Italy

Location

Ospedale La Memoria

Gavardo, 25085, Italy

Location

Ospedale San Giuliano

Giugliano in Campania, 80014, Italy

Location

Ospedale di Guastalla

Guastalla, 42016, Italy

Location

Az. Osp.Vito Fazzi

Lecce, 73100, Italy

Location

Ospedale Civile di Legnano

Legnano, 20025, Italy

Location

Az. Ospedaliera Desenzano sul Garda

Manerbio, 25025, Italy

Location

Fondazione Centro San Raffaele del Monte Tabor IRCCS

Milan, 20132, Italy

Location

Hesperia Hospital

Modena, 41100, Italy

Location

Nuovo Ospedale S. Agostino Estense - Baggiovara

Modena, 41100, Italy

Location

Ospedale Civile

Mondovì, 12084, Italy

Location

P.O. di Montebelluna

Montebelluna, 31044, Italy

Location

Ospedale Franchini

Montecchio, 42027, Italy

Location

Azienda Universitaria Federico II

Napoli, 80131, Italy

Location

Ospedale Santa Maria delle Grazie

Pozzuoli, 80078, Italy

Location

Arcispedale Santa Maria Nuova

Reggio Emilia, 42100, Italy

Location

Ospedale Civile

Riccione, 47038, Italy

Location

Ospedale degli Infermi

Rimini, 47900, Italy

Location

Ospedale S. Eugenio

Roma, 00100, Italy

Location

A.O. San Camillo

Roma, 00152, Italy

Location

Istituto Clinico Humanitas

Rozzano, 20089, Italy

Location

P.O. U.O. Struttura Complessa

San Giovanni Valdarno, 52027, Italy

Location

Ospedale della Valtiberina

Sansepolcro, 52037, Italy

Location

Ospedale Provinciale di Saronno

Saronno, 21047, Italy

Location

Nuovo Ospedale Civile di Sassuolo

Sassuolo, 41049, Italy

Location

Ospedale SS.Annunziata

Savigliano, 12028, Italy

Location

Ospedale M. Scarlato

Scafati, 84018, Italy

Location

Ospedale Magati

Scandiano, 42010, Italy

Location

Az. Ospedaliera Galmarini

Tradate, 21049, Italy

Location

Ospedale Cà Foncello

Treviso, 31100, Italy

Location

Specjalista Chorob Wewnetryznich

Będzin, 42500, Poland

Location

Oddzial Chorob Wewnetrznych

Brzesku, 32800, Poland

Location

Szpital Powiatowy w Chrzanowie

Chrzanów, 32500, Poland

Location

Oddzialu Kardiologicznego

Dąbrowa Górnicza, 41300, Poland

Location

Oddzialu Chorob Wewnetrznych

Dąbrowa Tarnowska, 32200, Poland

Location

II Oddzial Kardiologiczno - Wewnetrezny Szpital Miejski w Jawozznie

Jaworzno, 43600, Poland

Location

Oddzial Wewneztrnj Okregowy Szpital Kolciowy

Katowice, 40760, Poland

Location

First Dept. Cardiology - Gornoslaskiego Centrum Medycznego

Katowice, 41635, Poland

Location

Zaklad Hemodynamiki i Angiokardiografii Pracownia 1

Krakow, 31202, Poland

Location

Zaklad Hemodynamiki i Angiokardiografii - Pracownia 2

Krakow, 31501, Poland

Location

Oddzial Wewnetrzny - Szpital Mijski w Krynicy

Krynica, 33380, Poland

Location

Oddzial Wewnetrzny - Szpital Powiatowy w Limanowej

Limanowa, 34600, Poland

Location

Oddzial Internistyczno- kardiologiczny

Nowy Sącz, 33300, Poland

Location

Oddzial Kardiologiczny

Nowy Targ, 34400, Poland

Location

Szpital Powiatowy im. Sw. Maksimiliana w Oswiecimiu

Oświęcim, 32600, Poland

Location

Oddzial Intensywnej Opieki Kardiologicznej i Kardiologii Olgonej

Sosnowiec, 41200, Poland

Location

Zaklad Opieki Zdrowotnej

Sucha Beskidzka, 34-200, Poland

Location

Oddzial Wewnetrzny Szpital w Szczyrzu

Szczyrzyc, 34623, Poland

Location

Oddzial Kardiologii Inwazijnej - Szpital im. E. Szczeklika

Tarnów, 33100, Poland

Location

Oddzialu Kardiologii z OIOK

Tarnów, 33100, Poland

Location

Oddzial Kardiologii - Szpital Miejski w Tychach

Tychy, 43100, Poland

Location

Szpital Powiatowy im. Jana Pawla II w Wadowicach

Wadowice, 34100, Poland

Location

Oddzial Kardiologii - Szpital Powiatowy w Zakopane

Zakopane, 34500, Poland

Location

Related Publications (2)

  • Di Mario C, Bolognese L, Maillard L, Dudek D, Gambarati G, Manari A, Guiducci V, Patrizi G, Rusconi LC, Piovaccari G, Hibon AR, Belpomme V, Indolfi C, Olivari Z, Steffenino G, Zmudka K, Airoldi F, Panzarasa R, Flather M, Steg PG. Combined Abciximab REteplase Stent Study in acute myocardial infarction (CARESS in AMI). Am Heart J. 2004 Sep;148(3):378-85. doi: 10.1016/j.ahj.2004.03.038.

    PMID: 15389222BACKGROUND
  • Di Mario C, Dudek D, Piscione F, Mielecki W, Savonitto S, Murena E, Dimopoulos K, Manari A, Gaspardone A, Ochala A, Zmudka K, Bolognese L, Steg PG, Flather M; CARESS-in-AMI (Combined Abciximab RE-teplase Stent Study in Acute Myocardial Infarction) Investigators. Immediate angioplasty versus standard therapy with rescue angioplasty after thrombolysis in the Combined Abciximab REteplase Stent Study in Acute Myocardial Infarction (CARESS-in-AMI): an open, prospective, randomised, multicentre trial. Lancet. 2008 Feb 16;371(9612):559-68. doi: 10.1016/S0140-6736(08)60268-8.

MeSH Terms

Conditions

Myocardial Infarction

Interventions

Angioplasty, Balloon

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesInfarctionIschemiaPathologic ProcessesPathological Conditions, Signs and SymptomsNecrosis

Intervention Hierarchy (Ancestors)

AngioplastyCatheterizationTherapeuticsEndovascular ProceduresVascular Surgical ProceduresCardiovascular Surgical ProceduresSurgical Procedures, OperativeMinimally Invasive Surgical ProceduresInvestigative Techniques

Study Officials

  • Leonardo Bolognese, MD, Ph D

    Ospedale San Donato - Arezzo Italy

    PRINCIPAL INVESTIGATOR
  • Gabriel P. Steg, MD. Ph D

    Hopital Bichat - Paris France

    PRINCIPAL INVESTIGATOR
  • Darius Dudek, MD, Ph D

    Jagellonian University Krakow Poland

    PRINCIPAL INVESTIGATOR
  • Carlo Di Mario, MD

    Royal Brompton and Harefield Hospital - London UK

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER

Study Record Dates

First Submitted

September 13, 2005

First Posted

September 22, 2005

Study Start

May 1, 2003

Study Completion

March 1, 2007

Last Updated

July 3, 2007

Record last verified: 2005-09

Locations